DETERMINANTS OF INSULIN RESISTANCE AMONG PEOPLE LIVING IN A RURAL AREA OF INDONESIA

Abstract

INTRODUCTION
Worldwide prevalence of obesity has increased rapidly, of which the main driver is the rising of body weight among people living in the rural area. While obesity is one of the main risk factors for the development of type 2 diabetes (T2DM), in a rural area, other environmental factors might also play a role. This study aims to assess the determinants of insulin resistance (IR), the main pathogenesis of T2DM, among people living in a rural area of Indonesia.

METHODOLOGY
We analyzed the baseline data of the Sugarspin study (n=1669) which was conducted in Nangapanda, Flores Island, Indonesia. The influence of each risk factors to HOMA-IR, was analyzed using linear regression analysis.

RESULTS
The prevalence of IR was 27.8% and 28.2% for men and women respectively. Increasing BMI and waist circumference were associated with increasing IR. Increasing age was also associated with increasing IR, however, in men after the age of 55, further increment in age was not associated with increasing IR. Progressive increase in BMI was observed until the age of 40, which then plateau until the age of 55, and then decline afterward. Interestingly, helminth infection was independently associated with a lower IR.

CONCLUSION
 In a rural area, the main determinant of IR was similar to the one we observed in an urban area, which is obesity. However, the more prevalent infectious disease in a rural area might also directly or indirectly influence IR by its impact on obesity or other factors which need to be elucidated further.